The relationship of indwelling urinary catheters to death, length of hospital stay, functional decline, and nursing home admission in hospitalized older medical patients

J Am Geriatr Soc. 2007 Feb;55(2):227-33. doi: 10.1111/j.1532-5415.2007.01064.x.


Objectives: To determine the association between indwelling urinary catheterization without a specific medical indication and adverse outcomes.

Design: Prospective cohort.

Setting: General medical inpatient services at a teaching hospital.

Participants: Five hundred thirty-five patients aged 70 and older admitted without a specific medical indication for urinary catheterization.

Intervention: Indwelling urinary catheterization within 48 hours of admission.

Measurements: Death, length of hospital stay, decline in ability to perform activities of daily living (ADLs), and new admission to a nursing home.

Results: Indwelling urinary catheters were placed in 76 of the 535 (14%) patients without a specific medical indication. Catheterized patients were more likely to die in the hospital (6.6% vs 1.5% of those not catheterized, P=.006) and within 90 days of hospital discharge (25% vs 10.5%, P<.001); the greater risk of death with catheterization persisted in a propensity-matched analysis (hazard ratio (HR)=2.42, 95% confidence interval (CI)=1.04-5.65). Catheterized patients also had longer lengths of hospital stay (median, 6 days vs 4 days; P=.001); this association persisted in a propensity-matched analysis (HR=1.46, 95% CI=1.03-2.08). Catheterization was not associated (P>.05) with decline in ADL function or with admission to a nursing home.

Conclusion: In this cohort of older patients, urinary catheterization without a specific medical indication was associated with greater risk of death and longer hospital stay.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Catheters, Indwelling / adverse effects*
  • Female
  • Homes for the Aged / statistics & numerical data
  • Hospital Mortality*
  • Hospitalization / statistics & numerical data*
  • Humans
  • Length of Stay / statistics & numerical data*
  • Logistic Models
  • Male
  • Nursing Homes / statistics & numerical data
  • Prospective Studies
  • Treatment Outcome